Basic Information
| Provider Information | |||||||||
| NPI: | 1881726495 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AUGUSTO SILVA M D MEDICAL CORP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2601 W ALAMEDA AVE | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | BURBANK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 915054800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188462546 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2601 W ALAMEDA AVE | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | BURBANK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 915054800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188462546 | ||||||||
| FaxNumber: | 8188464047 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2007 | ||||||||
| LastUpdateDate: | 06/21/2018 | ||||||||
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| AuthorizedOfficialLastName: | SILVA | ||||||||
| AuthorizedOfficialFirstName: | AUGUSTO | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8188462546 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | A26585 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.